Dental care protocol for patients with Down syndrome: behavioral management and prevention of oral pathologies. Literature review
Keywords:
Down syndrome, dentistry, behaviorAbstract
Introduction: This review aimed to analyze the scientific literature related to dental care protocols for patients with Down syndrome, addressing the most relevant aspects of behavioral management and the prevention of oral pathologies. This genetic condition presents particular orofacial characteristics, such as macroglossia, narrow palate, and hypotonia, which influence oral function and complicate oral hygiene, increasing the risk of periodontal disease and caries. Materials and methods: A systematic search was conducted for scientific articles published between 2020 and 2025 in the PubMed database, using keywords in Spanish and English such as “Down syndrome,” “dental care,” “behavioral management,” and “oral prevention.” Twenty-six articles were selected from a total of 93 initially identified, meeting the established inclusion criteria: full text, clinical relevance, and direct application to the dental field. Results: The reviewed studies showed delayed tooth development, agenesis, short roots, and eruption abnormalities. Periodontal disease showed accelerated progression linked to immune dysfunction, while dental caries was associated with hyposalivation, enamel structural defects, and inadequate dietary habits. Behavioral management highlighted the need for individualized strategies based on empathetic communication and gradual adaptation to the clinical environment. Conclusion: The review revealed significant methodological variability and a lack of standardization in dental care protocols, which limits the comparability of results.
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Vieira TI, Cavalcanti YW, de Sousa SA, Santiago BM, Oliveira LB, Bitencourt FV, et al. Tooth wear prevalence in individuals with Down syndrome: a systematic review. Clin Oral Investig [Internet]. 2023 Mar 1 [cited 2025 Oct 30];27(3):943–53. Available from: https://pubmed.ncbi.nlm.nih.gov/36629964/
Papaefthymiou P, Ozbilen EO. Sella turcica morphometrics in subjects with down syndrome. J Stomatol Oral Maxillofac Surg [Internet]. 2023 Dec 1 [cited 2025 Oct 30];124(6). Available from: https://pubmed.ncbi.nlm.nih.gov/37442343/
Visser MM, Carvajal Monroy PL, Zuidgeest TGM. [Orthodontics in Down Syndrome]. Ned Tijdschr Tandheelkd [Internet]. 2025 May 6 [cited 2025 Oct 30];132(5):254–60. Available from: https://pubmed.ncbi.nlm.nih.gov/40331451/
García-García MT, Diz-Dios P, Abeleira-Pazos MT, Limeres-Posse J, García-Mato E, Varela-Aneiros I, et al. Cranial-Vertebral-Maxillary Morphological Integration in Down Syndrome. Biology (Basel) [Internet]. 2022 Apr 1 [cited 2025 Oct 30];11(4). Available from: https://pubmed.ncbi.nlm.nih.gov/35453698/
Alam MK, Alsharari AHL, Shayeb MAL, Elfadil S, Cervino G, Minervini G. Prevalence of bruxism in down syndrome patients: A systematic review and meta-analysis. J Oral Rehabil [Internet]. 2023 Dec 1 [cited 2025 Oct 30];50(12):1498–507. Available from: https://pubmed.ncbi.nlm.nih.gov/37507203/
Luconi E, Togni L, Mascitti M, Tesei A, Nori A, Barlattani A, et al. Bruxism in Children and Adolescents with Down Syndrome: A Comprehensive Review. Medicina (Kaunas) [Internet]. 2021 Mar 1 [cited 2025 Oct 30];57(3):1–10. Available from: https://pubmed.ncbi.nlm.nih.gov/33804484/
Spodzieja K, Olczak-Kowalczyk D. Premature Loss of Deciduous Teeth as a Symptom of Systemic Disease: A Narrative Literature Review. Int J Environ Res Public Health [Internet]. 2022 Mar 1 [cited 2025 Oct 30];19(6). Available from: https://pubmed.ncbi.nlm.nih.gov/35329073/
Hudson S, Abusido T, Sebastianski M, Castro-Codesal ML, Lewis M, MacLean JE. Long-Term Non-invasive Ventilation in Children With Down Syndrome: A Systematic Review. Front Pediatr [Internet]. 2022 May 23 [cited 2025 Oct 30];10. Available from: https://pubmed.ncbi.nlm.nih.gov/35676906/
Elrefadi R, Beaayou H, Herwis K, Musrati A. Oral health status in individuals with Down syndrome. Libyan J Med [Internet]. 2022 [cited 2025 Oct 30];17(1). Available from: https://pubmed.ncbi.nlm.nih.gov/36040407/
Octafianto A, Saskianti T, Wahluyo S, Tedjosasongko U, Novianti A, Sahar D. Gingivitis in Children with Down Syndrome: Review of Local and Systemic Factors. Acta Med Philipp [Internet]. 2023 [cited 2025 Oct 30];57(6):52–8. Available from: https://pubmed.ncbi.nlm.nih.gov/39483687/
Vicente A, Bravo-González LA, López-Romero A, Muñoz CS, Sánchez-Meca J. Craniofacial morphology in down syndrome: a systematic review and meta-analysis. Sci Rep [Internet]. 2020 Dec 1 [cited 2025 Oct 30];10(1). Available from: https://pubmed.ncbi.nlm.nih.gov/33199843/
Wintergerst A, López-Morales MP. Masticatory function in children with Down syndrome. Physiol Behav [Internet]. 2021 Jun 1 [cited 2025 Oct 30];235. Available from: https://pubmed.ncbi.nlm.nih.gov/33736969/
Ghaffarpour M, Karami-Zarandi M, Rahdar HA, Feyisa SG, Taki E. Periodontal disease in down syndrome: Predisposing factors and potential non-surgical therapeutic approaches. J Clin Lab Anal [Internet]. 2024 Jan 1 [cited 2025 Oct 30];38(1–2). Available from: https://pubmed.ncbi.nlm.nih.gov/38254289/
Murray A, Gough G, Cindrić A, Vučković F, Koschut D, Borelli V, et al. Dose imbalance of DYRK1A kinase causes systemic progeroid status in Down syndrome by increasing the un-repaired DNA damage and reducing LaminB1 levels. EBioMedicine [Internet]. 2023 Aug 1 [cited 2025 Oct 30];94. Available from: https://pubmed.ncbi.nlm.nih.gov/37451904/
Hendrix JA, Amon A, Abbeduto L, Agiovlasitis S, Alsaied T, Anderson HA, et al. Opportunities, barriers, and recommendations in down syndrome research. Transl Sci Rare Dis [Internet]. 2021 [cited 2025 Oct 30];5(3–4):99–129. Available from: https://pubmed.ncbi.nlm.nih.gov/34268067/
Yehia Z, Silbereisen A, Koletsi D, Arabzadehtousi M, Tsilingaridis G, Bostanci N. Efficacy of periodontal treatment modalities in Down syndrome patients: a systematic review and meta-analysis. Evid Based Dent [Internet]. 2024 Dec 1 [cited 2025 Oct 30];25(4):213–4. Available from: https://pubmed.ncbi.nlm.nih.gov/39183214/
Militi A, Nucera R, Chirieleison G, Fiorillo L, Cervino G, Portelli M. Down Syndrome children with obstructive sleep apnea. Minerva dental and oral science [Internet]. 2022 Oct 1 [cited 2025 Oct 30];71(5):287–92. Available from: https://pubmed.ncbi.nlm.nih.gov/36321622/
Borrelli M, Corcione A, Rongo R, Cantone E, Scala I, Bruzzese D, et al. Obstructive Sleep Apnoea in Children with Down Syndrome: A Multidisciplinary Approach. J Pers Med [Internet]. 2022 Jan 1 [cited 2025 Oct 30];13(1). Available from: https://pubmed.ncbi.nlm.nih.gov/36675732/
Schmidt P, Suchy LC, Schulte AG. Oral Health Care of People with Down Syndrome in Germany. Int J Environ Res Public Health [Internet]. 2022 Oct 1 [cited 2025 Oct 30];19(19). Available from: https://pubmed.ncbi.nlm.nih.gov/36231733/
de las Fuentes Monreal M, Capote Moreno AL, Wix Ramos R, Muñoz-Guerra MF, Rubio Bueno P. “Skeletal surgical approach in Down Syndrome with Obstructive Sleep Apnea.” Journal of Cranio-Maxillofacial Surgery [Internet]. 2024 Oct 1 [cited 2025 Oct 30];52(10):1155–63. Available from: https://pubmed.ncbi.nlm.nih.gov/39181745/
Goud EVSS, Gulati S, Agrawal A, Pani P, Nishant K, Pattnaik SJ, et al. Implications of Down’s syndrome on oral health status in patients: A prevalence-based study. J Family Med Prim Care [Internet]. 2021 Nov [cited 2025 Oct 30];10(11):4247–52. Available from: https://pubmed.ncbi.nlm.nih.gov/35136797/
Sande López L, García-Mato E, de Coo A, Cruz R, Antequera D, Diz P, et al. Salivary Lactoferrin Levels and Polymorphisms in Down Syndrome Individuals with Periodontitis. J Clin Med [Internet]. 2025 Mar 1 [cited 2025 Oct 30];14(6). Available from: https://pubmed.ncbi.nlm.nih.gov/40142623/
Salemi M, Cannarella R, Cimino L, Condorelli RA, Giurato G, Marchese G, et al. GPR56 gene down-regulation in patients with Klinefelter Syndrome: a candidate for infertility? Minerva endocrinology [Internet]. 2021 Dec 1 [cited 2025 Oct 30];46(4):384–8. Available from: https://pubmed.ncbi.nlm.nih.gov/33331742/
Lee SM, Taylor NF, Said C, Shields N. Community participation in adults with Down syndrome: a scoping review. Disabil Rehabil [Internet]. 2025 [cited 2025 Oct 30];47(21). Available from: https://pubmed.ncbi.nlm.nih.gov/40062523/
Hok P, Strauss S, McAuley J, Domin M, Wang AP, Rae C, et al. Functional connectivity in complex regional pain syndrome: A bicentric study. Neuroimage [Internet]. 2024 Nov 1 [cited 2025 Oct 30];301. Available from: https://pubmed.ncbi.nlm.nih.gov/39424016/
Ashi H. Dental Caries Experience among Down’s Syndrome Population in Saudi Arabia - A Systematic Review. Niger J Clin Pract [Internet]. 2021 Aug 1 [cited 2025 Oct 30];24(8):1109–16. Available from: https://pubmed.ncbi.nlm.nih.gov/34397017/
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